Organization
THRIFTY PAYLESS INC
Active
Other names
RITE AID PHARMACY 05288
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ZOREK (MANAGER ONLINE ADJUDICATION)
(717) 975-5937
Entity
Organization
Contact information
Practice address
364 TRIANGLE CENTER, LONGVIEW, WA 98632-4651
(360) 423-4833
Mailing address
200 NEWBERRY COMMONS, ETTERS, PA 17319-9363
(717) 761-2633
(717) 975-8659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262010404293
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4921551
OTHER ID NUMBER
—
05
—
500630761
—
OR
01
—
500641934
MEDICAID DME
OR
05
—
6017032
—
WA
Enumeration date
07/31/2006
Last updated
02/14/2012
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